Staging of brain pathology related to sporadic Parkinson’s disease

Sporadic Parkinson’s disease involves multiple neuronal systems and results from changes developing in a few susceptible types of nerve cells. Essential for neuropathological diagnosis are α-synuclein-immunopositive Lewy neurites and Lewy bodies. The pathological process targets specific induction s...

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Bibliographic Details
Published in:Neurobiology of aging 2003-03, Vol.24 (2), p.197-211
Main Authors: Braak, Heiko, Tredici, Kelly Del, Rüb, Udo, de Vos, Rob A.I, Jansen Steur, Ernst N.H, Braak, Eva
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Brain - pathology
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Female
Humans
Lewy bodies
Lewy Bodies - pathology
Lewy Body Disease - pathology
Lewy neurites
Limbic system
Male
Medical sciences
Medulla Oblongata - pathology
Motor system
Neocortex - pathology
Neurology
Parkinson Disease - pathology
Parkinson’s disease
Staging procedure
Temporal Lobe - pathology
α-synuclein
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Summary:Sporadic Parkinson’s disease involves multiple neuronal systems and results from changes developing in a few susceptible types of nerve cells. Essential for neuropathological diagnosis are α-synuclein-immunopositive Lewy neurites and Lewy bodies. The pathological process targets specific induction sites: lesions initially occur in the dorsal motor nucleus of the glossopharyngeal and vagal nerves and anterior olfactory nucleus. Thereafter, less vulnerable nuclear grays and cortical areas gradually become affected. The disease process in the brain stem pursues an ascending course with little interindividual variation. The pathology in the anterior olfactory nucleus makes fewer incursions into related areas than that developing in the brain stem. Cortical involvement ensues, beginning with the anteromedial temporal mesocortex. From there, the neocortex succumbs, commencing with high order sensory association and prefrontal areas. First order sensory association/premotor areas and primary sensory/motor fields then follow suit. This study traces the course of the pathology in incidental and symptomatic Parkinson cases proposing a staging procedure based upon the readily recognizable topographical extent of the lesions.
ISSN:0197-4580
1558-1497
DOI:10.1016/S0197-4580(02)00065-9